Restrictive Opioid Prescribing Protocols Following Total Hip Arthroplasty and Total Knee Arthroplasty Are Safe and Effective

Andrew J Holte; Christopher N Carender; Nicolas O Noiseux; Jesse E Otero; Timothy S Brown

doi:10.1016/j.arth.2019.02.022

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Restrictive Opioid Prescribing Protocols Following Total Hip Arthroplasty and Total Knee Arthroplasty Are Safe and Effective

Journal article

Peer reviewed

Restrictive Opioid Prescribing Protocols Following Total Hip Arthroplasty and Total Knee Arthroplasty Are Safe and Effective

Andrew J Holte, Christopher N Carender, Nicolas O Noiseux, Jesse E Otero and Timothy S Brown

The Journal of arthroplasty, Vol.34(7S), pp.S135-S139

07/2019

DOI: 10.1016/j.arth.2019.02.022

PMID: 30890390

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Abstract

Orthopedic surgeons may overprescribe opioids postoperatively. Literature examining opioid prescribing guidelines following total joint arthroplasty (TJA) is limited. Retrospective review was conducted of primary TJAs from June 2017 to February 2018, with 3-month follow-up. Patients were divided into those who underwent surgery before (historical cohort) and after (restrictive cohort) implementation of a strict postoperative opioid prescribing protocol. Three hundred ninety-nine total patients were included (282 in historical cohort, 117 in restrictive cohort). There was no significant difference in preoperative, perioperative, and postoperative inpatient opioid use. Historical cohort was given significantly larger initial prescriptions, received significantly more refills, and received significantly greater total quantity of opioids per patient. There were significantly fewer call-ins in the restrictive cohort. Clinical outcomes were not significantly different. Drastic reductions in opioid prescriptions following TJA are possible without an increase in refills, call-ins, or adverse clinical effects.

total hip arthroplasty

total knee arthroplasty

opioid

pain control

opiate

Details

Title: Subtitle: Restrictive Opioid Prescribing Protocols Following Total Hip Arthroplasty and Total Knee Arthroplasty Are Safe and Effective
Creators: Andrew J Holte - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA
Christopher N Carender - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA
Nicolas O Noiseux - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA
Jesse E Otero - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA
Timothy S Brown - Department of Orthopedics and Rehabilitation, University of Iowa Hospitals and Clinics, Iowa City, IA
Resource Type: Journal article
Publication Details: The Journal of arthroplasty, Vol.34(7S), pp.S135-S139
DOI: 10.1016/j.arth.2019.02.022
PMID: 30890390
NLM abbreviation: J Arthroplasty
ISSN: 0883-5403
eISSN: 1532-8406
Publisher: United States
Language: English
Date published: 07/2019
Academic Unit: Orthopedics and Rehabilitation
Record Identifier: 9984040386802771

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